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Minimally invasive image-guided therapy of primary and metastatic pancreatic cancer

World Journal of Gastroenterology 2021年第27期27卷 4322-4341页

作者： Andras Bibok Dae Won Kim mokeng. malafa Bela Kis Department of Diagnostic Imaging and Interventional Radiology H.Lee Moffitt Cancer CenterTampaFL 33612United States Department of Transplantation&Surgery Radiology UnitSemmelweis UniversityBudapest 1085Hungary Department of Gastrointestinal Oncology H.Lee Moffitt Cancer CenterTampaFL 33612United States

Pancreatic cancer is a challenging malignancy with limited treatment options and poor life *** only curative option is surgical resection,but only 15%-20%of patients are resectable at presentation because more than 50%of patients has distant metastasis at diagnosis and the rest of them has locally advanced pancreatic cancer(LAPC).The standard of care first line treatment for LAPC patients is chemotherapy with or without radiation *** developments in minimally invasive ablative techniques may add to the treatment armamentarium of *** are increasing number of studies evaluating these novel ablative techniques,including radiofrequency ablation,microwave ablation,cryoablation and irreversible *** studies which included pancreatic tumor ablation,demonstrated improved overall survival in LAPC ***,the exact protocols are yet to set up to which stage of the treatment algorithm ablative techniques can be added and in what kind of treatment *** with metastatic pancreatic cancer has dismal prognosis with 5-year survival is only 3%.The most common metastatic site is the liver as 90%of pancreatic cancer patients develop liver *** is the primary treatment option for patients with metastatic pancreatic ***,when the tumor is not responding to chemotherapy or severe drug toxicity develops,locoregional liver-directed therapies can provide an opportunity to control intrahepatic disease progression and improve survival in selected *** the last decade new therapeutic options arose with the advancement of minimally invasive technologies to treat pancreatic cancer *** new therapies have been a topic of increasing interest due to the severe prognostic implications of locally advanced and metastatic pancreatic cancer and the low comorbid risk of these *** review summarizes new ablative options for patients with LAPC and percutaneous liver-directed th

关键词： Pancreatic neoplasms Interventional radiology Ablation techniques Electroporation Radiofrequency ablation Therapeutic embolization

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MicroRNAs in pancreatic ductal adenocarcinoma

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World Journal of Gastroenterology 2011年第7期17卷 817-827页

作者： Jong Y Park James Helm Domenico Coppola Donghwa Kim mokeng. malafa Seung Joon Kim Division of Cancer Prevention and Control Moffitt Cancer Center FL 33612 United States Gastrointestinal Tumor Program Moffitt Cancer Center FL 33612 United States Department of Anatomic Pathology Moffitt Cancer Center FL 33612 United States Department of Molecular Oncology MoffittCancer Center FL 33612 United States Department of Internal Medicine Collegeof Medicine the Catholic University of Korea Seoul 137-040South Korea

Ductal adenocarcinoma of the pancreas is a lethal cancer for which the only chance of long-term survival belongs to the patient with localized disease in whom a potentially curative resection can be done. Therefore, biomarkers for early detection and new therapeutic strategies are urgently needed. miRNAs are a recently discovered class of small endogenous non-coding RNAs of about 22 nucleotides that have gained attention for their role in downregulation of mRNA expression at the post-transcriptional level. miRNAs regulate proteins involved in critical cellular processes such as differentiation, proliferation, and apoptosis. Evidence suggests that deregulated miRNA expression is involved in carcinogenesis at many sites, including the pancreas. Aberrant expression of miRNAs may upregulate the expression of oncogenes or downregulate the expression of tumor suppressor genes, as well as play a role in other mechanisms of carcinogenesis. The purpose of this review is to summarize our knowledge of deregulated miRNA expression in pancreatic cancer and discuss the implication for potential translation of this knowledge into clinical practice.

关键词： microRNA 胰腺癌 miRNA mRNA表达放松管制抑癌基因生物标志物转录后水平

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Prognostic value of pre-treatment F-18-FDG PET-CT in patients with hepatocellular carcinoma undergoing radioembolization

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World Journal of Gastroenterology 2016年第47期22卷 10406-10414页

作者： Yazan Abuodeh Arash O Naghavi Kamran A Ahmed Puja S Venkat Youngchul Kim Bela Kis Junsung Choi Benjamin Biebel Jennifer Sweeney Daniel A Anaya Richard Kim mokeng. malafa Jessica M Frakes Sarah E Hoffe Ghassan El-Haddad Department of Radiation Oncology H Lee Moffitt Cancer Center and Research Institute Department of Interventional Radiology H Lee Moffitt Cancer Center and Research Institute Department of Gastrointestinal Oncology H Lee Moffitt Cancer Center and Research Institute

AIM To evaluate the value of pre-treatment 18F-FDG PET/CT in patients with HCC following liver *** We identified 34 patients with HCC who underwent an FDG PET/CT scan prior to hepatic radioembolization at our institution between 2009 and 2013. Patients wereseen in clinic one month after radioembolization and then at 2-3 mo intervals. We assessed the influence of FDG tumor uptake on outcomes including local liver control(LLC), distant liver control(DLC), time to distant metastases(DM), progression free survival(PFS) and overall survival(OS).RESULTS The majority of patients were males(n = 25, 74%), and had Child Pugh Class A(n = 31, 91%), with a median age of 68 years(46-84 years). FDG-avid disease was found in 19(56%) patients with SUVmax ranging from 3 to 20. Female patients were more likely to have an FDG-avid HCC(P = 0.02). Median follow up of patients following radioembolization was 12 months(1.2-62.8 mo). FDG-avid disease was associated with a decreased 1 year LLC, DLC, DM and PFS(P < 0.05). Using multivariate analysis, FDG avidity predicted for LLC, DLC, and PFS(all P < 0.05).CONCLUSION In this retrospective study, pre-treatment HCC FDGavidity was found to be associated with worse LLC, DLC, and PFS following radioembolization. Larger studies are needed to validate our initial findings to assess the role of F-18-FDG PET/CT scans as biomarker for patients with HCC following radioembolization.

关键词： F-18 fluorodeoxyglucose 宠物 Hepatocellular 癌 Radioembolization 预后 Biomarker

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CDX2 protein expression compared to alcian blue staining in the evaluation of esophageal intestinal metaplasia

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World Journal of Gastroenterology 2015年第9期21卷 2770-2776页

作者： Dennis R Johnson Maisoun Abdelbaqui Maryam Tahmasbi Zoltan Mayer Hung-Wei Lee mokeng. P malafa Domenico Coppola Department of Anatomic Pathology Moffitt Cancer Center and Research InstituteTampaFL 33612United States Florida Digestive Health Specialists Lakewood RanchFL 34202United States Department of Oncological Sciences University of South FloridaTampaFL 33612United States GI Tumor Program Moffitt Cancer Center and Research InstituteTampaFL 33612United States Tumor Biology Program Moffitt Cancer Center and Research InstituteTampaFL 33612United States

AIM:To compare the sensitivity and specificity of CDX2 and alcian blue(AB) p H 2.5 staining in identifying esophageal intestinal ***:One hundred and ninty-nine biopsies from 186 patients were retrospectively reviewed and categorized as Barrett's esophagus(BE)(n =108); non-Barrett's esophagus(NBE)(n =48); columnar blue cells(CB) and esophageal glands(EG)(n =43).The biopsies were stained with AB and immunostained for CDX2 using a mouse monoclonal antibody from Biogenex(clone CDX2-88) and the Ventana Discovery X automated *** positive and negative predictive value of each group was used to determine the predictive power of CDX2 and AB in diagnosing intestinal ***:All of the 108 BE biopsies(100%) were positive for AB and 102 of them(94.4%) were positive for *** six BE patients(5.6%) who failed to stain with CDX2 were found to have lost the focus of intestinal metaplasia upon deeper sectioning for *** AB and CDX2 were negative in 43 out of 48(89.6%) NBE *** NBE patients(10.4%) were falsely positive for AB due to the presence of EG and CB in these *** cases were all CDX2 *** addition,5 AB negative NBE were found to be CDX2 *** on these results the CDX2 immunostain had similar sensitivity but higher specificity(100% vs about 91%) than AB in detecting intestinal type metaplasia in these *** data shows that CDX2 has a better PPV in detecting intestinal metaplasia as compared to AB(95.6% vs 71.5%,respectively).CONCLUSION:CDX2 has a better positive predictive value than AB in detecting intestinal ***2may be useful when challenged by gastro-esophageal biopsies containing mimikers of BE.

关键词： Barrett’s esophagus Alcian blue pH 2.5 CDX2 Intest

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